[Surgical treatment of biliary cystic fistula caused by hydatic cysts. Apropos of 83 cases]

J Chir (Paris). 1997 Aug;134(3):114-8.
[Article in French]

Abstract

The high number of BCF (10-24%) diseases with its direct link on post-surgical casualties require a very well structured therapy. A study over a period of 17 years on 479 patients, whose age ranged average 37 years, broLen into 52 female et 31 male, shows 83 cases of hydatic livercystis that were aggravated by a BCF. In 23 cases (27.7%) the BCF was large, minimal in 60 cases (72.3%) and for 72% the multivesicular hydatic cystis was altered by a pericystis, often sclerous and calcified. In 9 cases (11%) the main biliary duct was enlarged and showed hydatic remains. 3 patients were under radical treatment (3.6%), 2 (2.45%) underwent a total pericystectomy, and 1 (1.2%) a partial pericystectomy. The 80 other patients went through a saving approach treatment which involved. In 44 cases (55%) a flattening with a simple suture of BCF, in 11 cases (13.75%) a suture combined with an external bile drainage, in 5 cases (6.25%) a suture combined with an epiploic-plastic surgery, in 5 cases (6.25%) the suture was combined with the padding of the residual cavity, in 4 cases (5%) the epiploic plastic surgery was combined with an external bile drainage. In 7 cases (8.75%) a bipolar drainage was used and in 4 cases (5%) there was mobile drainage. For 50% of these patients the post surgical surgery was very simple; the most important aggravations were 12 FBK, 8 subphrenic abscess, 1 choleperitonitis. The average length of stay was 23 days. No death was accounted for. The aim was to assess the different technics proposed in the treatment of BCF and elaborate a therapeutical strategy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biliary Fistula / diagnostic imaging
  • Biliary Fistula / etiology
  • Biliary Fistula / surgery*
  • Decision Trees
  • Drainage / methods
  • Echinococcosis, Hepatic / complications
  • Echinococcosis, Hepatic / diagnostic imaging
  • Echinococcosis, Hepatic / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography